On September 15, the medical student Twitterverse went insane with the crash of ERAS. Students who had worked so hard on their applications had to deal with the uncertainty of a system that is supposed to work in our favor. I can speak to this panic and uncertainty personally, having spent the following day running out of AMSA office meetings to make sure that my applications were submitted on time.
I believe that this speaks to a larger problem within the culture of medicine and medical education. We live in a system where failure is not tolerated on any level. ERAS cannot fail, but neither can we as medical students. We feel a need to strive for perfect board scores and grades, and to act like any mistakes that we have made never happened. But what we really need to do is create a safe space for students to discuss failure, our fears, and our mistakes because they do exist. This culture currently forces us to hide these, and it leads to unintended consequences: students taking Ritalin to study for 16 hours straight or lying about findings that were not performed on a physical exam.
Something has to give. We show patients compassion but leave none for ourselves. In our current system, there is little formal time dedicated to discussing failure. In the silo of their own institutions, students can be reluctant to discuss their shortcomings for fear of how they will be perceived. Perhaps it would be beneficial to have collaboration on a national front, to be able to discuss these important topics with those outside our institutions in order to feel more secure. It is incredibly hard to change institutional culture, but until we try, students will continue to be driven toward the dream of perfectionism, leading to negative consequences as evidenced by our high rates of depression and burnout. To be able to discuss fear and failure openly will ultimately serve us as future physicians because we all make mistakes and will continue to do so. We are all in this experience together and can only truly relate once we are honest with ourselves and with others.
By the time fourth-years are reading this, your rank lists will have been submitted and you will be fervently awaiting the Match results, as I will be. I wish you the best of luck, and may the odds be ever in your favor.
Dr. Britani Kessler is AMSA’s national president and a recent graduate of Nova Southeastern University College of Osteopathic Medicine.